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• Clinical Article •
Differentiation between recurrent gliomas and radiation-induced brain injuries using DCE-MRI
BAI Xue-dong  SUN Xi-lin  WANG Dan  HE Chun-bo  LIU Fang  GAO Chao  YU Meng-meng  JI Yang  Chan Queenie 

DOI:10.3969/j.issn.1674-8034.2014.01.001.


[Abstract] Objective: To analysis whether hemodynamic parameters derived from dynamic contrast-enhanced (DCE) T1-weighted magnetic resonance imaging (MRI) can be used to distinguish recurrent gliomas from radiation-induced brain injury.Materials and Methods: Twenty eight patients who were being treated for glial neoplasms underwent conventional and DCE-MRI using a Philips 3.0 T scanner. Penetration analysis software can be applied to obtain T1-weighted signal intensity-time curves. The pharmacokinetic modelling was based on a two-compartment model that allows for the calculation of Ktrans (transfer constant between intravascular and extravascular, extracellular space), Ve (extravascular, extracellular space), kep (transfer constant from the extracellular, extravascular space into the plasma), Regions of interest (ROIs) were drawn manually around the entire recurrence-suspected contrast enhanced region which was measured three times and then obtain average value. A definitive diagnosis was established at subseuent surgical resection (seventeen) or clinicoradiologic follow-up (eleven). nonparametric test was uesd to determine whether there was a difference between glioma recurrence and radiation-induced brain injury.Results: The Ktrans, Ve, Kep values in the normal white matter were significantly different than those in the radiation necrosis and recurrent gliomas (P<0.01). The significantly different hemodynamic parameters between the recurrent tumor lesions and theradiation-induced necrotic sites were Ktrans and Ve, which were significantly higher in the recurrent glioma group than in the radiation necrosis group (P<0.01). A Ktrans cutoff value higher than 0.12 showed 100% sensitivity and 87% specificity for detecting the recurrent gliomas, The area under the ROC curve of Ktrans is 0.974 (P<0.01) and Ve is 0.872 (P=0.01). The kep values in recurrent tumors were not significantly higher than those in radiation-induced necrotic lesions (P>0.05).Conclusions: DCE-MRI can be used to identify glioma recurrence with radiation-induced brain injury, Ktrans value and Ve value have important clinical significance.
[Keywords] Glioma；Radiotherapy；Brain injuries；Neoplasm recurrence, local；Magnetic resonance imaging

BAI Xue-dong Radiology Department, the Affiliated Hospital of Chengde Medical College, Chengde 067000, China; Radiology Department, the Fourth Affiliated Hospital of Harbin Medical University, Harbin 150001, China

SUN Xi-lin Radiology Department, the Fourth Affiliated Hospital of Harbin Medical University, Harbin 150001, China

WANG Dan* Radiology Department, the Fourth Affiliated Hospital of Harbin Medical University, Harbin 150001, China

HE Chun-bo Department of Radiotherapy and Chemotherapy, the Fourth Affiliated Hospital of Harbin Medical University, Harbin 150001, China

LIU Fang Radiology Department, the Fourth Affiliated Hospital of Harbin Medical University, Harbin 150001, China

GAO Chao Radiology Department, the Fourth Affiliated Hospital of Harbin Medical University, Harbin 150001, China

YU Meng-meng Radiology Department, the Fourth Affiliated Hospital of Harbin Medical University, Harbin 150001, China

JI Yang Radiology Department, the Fourth Affiliated Hospital of Harbin Medical University, Harbin 150001, China

Chan Queenie Philips Healthcare, Hong Kong, China

*Correspondence to: Wang D, E-mail: hrbwangdan@126.com

Conflicts of interest   None.

Received  2013-03-19
Accepted  2013-07-28
DOI: 10.3969/j.issn.1674-8034.2014.01.001
DOI:10.3969/j.issn.1674-8034.2014.01.001.

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